Surgical treatment of neuroendocrine tumors of the pancreas. A single institution's experience

Abstract

Introduction: Neuroendocrine tumors of the pancreas (pNET) range from 1 to 2% of pancreatic oncological pathology, the frequency during lifetime diagnostics is 12–15 cases per 1 million of population. Aim: Introduce the largest experience of surgical treatment of neuroendocrine tumors of the pancreas in Ukraine. Methods: In the National Institute of Surgery and Transplantology from January 2004 to December 2014 were treated 173 patients with neuroendocrine tumors of the pancreas, to whom were performed 181 surgeries. Non-functioning pNET were diagnosed in 103 patients (59.5%), hormone-active were in 70 (40.5%). In non-functioning NET (dominated resection surgeries (Whipple procedure, left-side pancreatectomy), at hormone-active were performed mostly organ-preserving surgeries (enucleation of tumor). Results: Postoperative complications occurred in 18.4% of patients with pNET, the most common complication was external pancreatic fistula (9.8%). Total postoperative mortality was 1.2%. The overall 5-year survival was 82.3%, NET G1 - 100%, NET G2 - 84.3%, neuroendocrine carcinoma, NEC G3 – 38.7%. Conclusion: The level of postoperative complications and mortality indicators complies with all tumors of the pancreas. The level of the overall 5-year survival is quite high, allowing for organ-preserving and laparoscopic surgeries for localized forms of pNET. Advance forms of pNET are not a contraindication to surgical treatment, but such cases must be evaluated individually. Relatively few of occurrences of pNET, the complexity and importance of preoperative diagnostic to choose the optimal treatments strategy, justifying perform the treatment of these patients in specialized centers.